title: Challenges associated with transition to caregiver role following diagnostic disclosure of Alzheimer disease: a descriptive study.
abstract: BACKGROUND
  The prevalence of Alzheimer's disease is rising. The large number of new cases identified each year means that many new families will set upon a long trajectory of caring for a relative with dementia. Diagnostic disclosure of Alzheimer's disease marks the official transition to the caregiver role, yet this early period of the caregiver career have rarely been studied.
  
  
  OBJECTIVE
  Based on Meleis's theoretical framework for role transition, the objectives of this study were to document the characteristics of the caregiving context during the transition to the caregiver role following diagnostic disclosure of Alzheimer's disease and to compare these characteristics by caregiver gender and kinship tie to the relative.
  
  
  METHODS
  A descriptive design was used. Data were collected using standardized measures selected in accordance with the role transition theoretical framework. The sample recruited in Quebec (Canada) cognition clinics comprised 122 caregivers of an elderly relative diagnosed with Alzheimer's disease in the past nine months.
  
  
  RESULTS
  Findings reveal the context of care to be marked by several challenges for caregivers. The majority of caregivers receives little informal support, has poor knowledge of available formal services, and has difficulty planning ahead for the relative's future care needs. Caregivers themselves report a lack of preparedness to provide care. Compared with men caregivers, women seem to have more problems controlling disturbing thoughts about their new caregiver role and to experience more family conflicts and psychological distress. Compared with offspring caregivers, spouse caregivers are less able to respond to the relative's disruptive behaviors, make less use of problem-solving strategies, and report fewer family conflicts.
  
  
  CONCLUSIONS
  The challenges faced by caregivers during the transition to the caregiver role are sensitive to nursing interventions. Pro-active interventions from the outset of the caregiving career, such as early assessment of caregiver needs for support and of caregiver preparedness to provide care as well as early psycho-educational interventions, are essential to foster positive caregiver responses to the challenges of their new role.
authors.affiliation: Université de Montréal, and Holder of the Desjardins Research Chair in Nursing Care for Seniors and Their Families, Centre de recherche, Institut universitaire de gériatrie de Montréal, Canada. francine.ducharme@umontreal.ca
authors.forename: Francine
authors.initials: F
authors.lastname: Ducharme
authors.forename: Louise
authors.initials: L
authors.lastname: Lévesque
authors.forename: Lise
authors.initials: L
authors.lastname: Lachance
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Kergoat
authors.forename: Renée
authors.initials: R
authors.lastname: Coulombe
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000451:nursing*; D017028:Caregivers / Q000523:psychology; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020377:Self Efficacy; D013315:Stress, Psychological